As doctors adapt to improved technology, fewer go it alone

After meeting with a patient at Centegra Hospital – McHenry, Dr. Irfan Hafiz wiped his hands with sanitizer, sat down at a desk, and began dictating notes into a phone.

Hafiz then looked at a computer screen to view an electronic image of a CT scan of his next patient. Gone are the days of holding films up to the light – just one of the many changes in the medical field during the 16 years he has been practicing.

As hospitals and medical professionals celebrate Doctors’ Day, which was established in 1990 on a national level, physicians have seen many changes over the years in how they do their jobs.

Hafiz, who has been practicing since 1997, is a member of Metro Infectious Disease Consultants. He said more physicians are becoming part of medical groups or employed by hospitals.

“One is the mindset of [job] security,” said Hafiz, who also is the vice president of Medical Affairs for Centegra Health System. “Having someone else take care of the regulatory headaches, the paperwork and the administrative stuff ... it’s somebody else’s problem, not mine.”

Dr. Leo Kelly works at Advocate Good Shepherd Hospital in Barrington, where is he is a physician of internal medicine but does mostly administrative work.

Even though physicians tend to be independent-minded and entrepreneurial, many are no longer running private practices, Kelly said.

There are costs to starting and maintaining a practice. The doctor would have to hire a nurse, a receptionist, someone to handle billing and a computer expert.

“Running an office becomes expensive,” Kelly said.

Couple that with medical school debt, and being employed is becoming more popular.

Many medical school graduates are leaving with a large of amount of debt, sometimes as much as $200,000 to $250,000.

“It is an issue,” Kelly said.

However, there is a shortage of primary care physicians, as salaries have been flat or declining, Kelly said.

“The common notion is physicians make a good living, and most of their career they do,” Kelly said.

Although medicine is entirely about changes in patients’ lives as they go through illnesses and age, there have been changes over the years in how doctors do their jobs.

“We should be equipped to deal with change,” Kelly said.

The tools and programs physicians use have changed in the 30 years Kelly has been a physician. The technology and the science have evolved and improved.

How doctors chart and do paperwork has improved, too.

“Physicians don’t like the paperwork,” Kelly said. “I don’t think they liked it 30 years ago; they don’t like it now.”

Doctors are able to do charting and documenting via electronic records now. Writing notes in charts is starting to become less common.

“My handwriting was never good,” Kelly said. “Thankfully with electronic medical records, everyone could read what I write now.”

With health care reform coming, there will be some adjustment, Hafiz said.

“I don’t think anyone knows for sure,” Hafiz said. “I think the only thing for certain is there will be change.”

Kelly said one good thing coming with the Affordable Care Act is the increased access to health care for people, as insurance companies can’t exclude patients for pre-existing conditions and younger adults are able to stay on their parents’ insurance until age 26.

“Those things are good,” Kelly said.

Kelly said health care reform was a step in the right direction of concentrating on preventive care.

“Rather than incident-based care, we treat a population to keep them healthy,” Kelly said.

A trend toward employed physicians

According to the American Medical Association, in 2008:

• 61.1 percent of physicians were self-employed or owned a private practice

• 33.7 percent were employees of a hospital or medical group

• 5.2 percent were independent contractors

A recent study by consulting firm Accenture, however, showed independent physicians have been declining by 2 percent a year. Accenture forecasts a 5 percent annual decline through 2013, leading to only one-third of physicians in independent practice.